The comparison of nailfold capillaroscopic changes with clinical symptoms and laboratory results of scleroderma patients

Introduction: Systemic sclerosis is a disease which is associated with vascular lesions, skin fibrosis and major organ involvement such as lungs, kidneys and heart. Capillaroscopic changes in nail bed may be in relationship with disease activity. The purpose of this study was to seek for possible relationship between capillaroscopic changes and clinical and laboratory findings. Material and Method: Patients with SSc (46 female, 2 male) were evaulated for the existance of nail bed capillaroscopic changes, modified rodnan skin scoring (MRSS), blood serology, raynoud phenomena, interstitial lung disease (İLD) and pulmonary hypertension (PAH). Results: Patients with late stage capillaroscopic findings (22 patients) had more Scl -70 autoantibody positivity, pulmonary hypertension, higher modified rodnan skin scores (MRSS) and digital ulcer development compare to early/ active stage capillaroscopic findings. Patients with high MRSS (> 15) scores had an late stage nail bed capillaroscpy findings (p< 0.005) There was a positive correlation between ILD and Anti-scl-70 autoantibody and negative correlation with anti-centromer antibody. Besides, there was an inverse correlation between anti-Ro52 and anti-scl 70 antibody positivity. Discussion: According to our results, Scl autoantibody positivity in early stage may suggest and early development of microvascular damage and progressing to late stage capillaroscopic nail bed changes. Therefore, late stage capilloroscopic changes with high MRSS (> 15) should be an alert to physicians to follow patients closely for possible pulmonary artery hypertension development. inverse correlation between anti-Ro52 and anti-scl 70 antibody positivity may suggest the coexistence of ro52 positivity in limited scleroderma patients